目的:通过卷烟购买任务(CPT)评估中国吸烟者的卷烟需求,并评估不同假设情景下的卷烟价格,以实现中国降低吸烟率的目标。
方法:在研究中,447名参与者在试验的基线评估中完成了假设的CPT,因此,使用指数需求模型的指数化版本对每个参与者分别拟合了香烟需求曲线.通常,得出了五个需求指数,强度(空闲时的消费),断点(消费被抑制为0的第一个价格),最大输出(Omax),最高价格(Pmax,Omax发生的价格),和弹性(需求量的变化与价格变化的比率)。使用单向方差分析来探索卷烟购买任务指数与社会人口统计学和吸烟特征之间的相关性。采用单向衰减模型来模拟戒烟率,并在一系列情况下确定最佳卷烟价格,以实现20%的吸烟率。
结果:从CPT得出的价格弹性为0.54,表明价格上涨10%可以使参与吸烟者的吸烟减少5.4%。收入较高的吸烟者对卷烟价格的敏感性较低(弹性=-2.31,P=0.028)。卷烟采购任务指数在常用卷烟价格不同的吸烟者中差异显著,烟草依赖,和吸烟量。消费较高价格香烟的吸烟者报告了较高的断点,Omax和Pmax,但强度较低(P=0.001)。中度或高度依赖尼古丁的吸烟者报告强度较高,断点,Omax和Pmax,强度较低(P=0.001)。吸烟量较高的吸烟者报告的强度和Omax较高,和较低的强度(P<0.001)。实现中国内地吸烟率降至20%的目标,我们估计了在一系列情况下戒烟率和价格的预期涨幅,考虑到性别差异和减少吸烟开始。在方案(A)中,为了实现20%的吸烟率目标,在没有新吸烟者的情况下,目前有24.81%的吸烟者有必要戒烟。我们的拟合模型得到相应的价值为59.64元(95CI53.13-67.24)。考虑到情景(B)中只有男性戒烟的假设,理想的戒烟率为25.82%,用较高的对应价格62.15元(95CI55.40-70.06)诱导期望停止率。在拟议的方案(c)中,吸烟率减少的40%来自减少吸烟开始,由于香烟价格上涨,女性和男性同样戒烟,每包香烟的价格至少为37.36元(95CI32.32-42.69)(等于5.20美元),以达到14.89%的戒烟率。在方案(d)中,考虑到吸烟开始减少,只有男性因卷烟价格上涨而戒烟,相应的戒烟率应为15.49%,所需价格为38.60元(95CI33.53-44.02)。在对情景(C)中的教育水平和收入水平进行调整后,香烟的价格至少为37.37元/包(等于5.20美元)(95CI30.73-44.94)和37.84元/包(等于5.26美元)(95CI31.94-44.53),分别。
结论:卷烟采购任务指数与常用卷烟的收入水平和价格显著相关,烟草依赖程度,和吸烟量,这对研究影响吸烟行为的价格因素很有启发。有人建议,更高的香烟价格,超过当前的实际市场水平,在中国大陆势在必行。应采取更强有力的政策措施,提高烟草税和卷烟零售价格,以实现健康中国2030年将吸烟率降低至20%的目标。
OBJECTIVE: To assess cigarette demand among Chinese smokers through a cigarette purchase task (CPT) and to evaluate cigarette prices under different hypothetical scenarios in order to meet the goals of smoking prevalence reduction in China.
METHODS: In the study, 447 participants completed a hypothetical CPT at baseline assessments of a trial, thus, cigarette demand curves were individually fitted for each participant using an exponentiated version of the exponential demand model. Typically, five demand indices were derived, intensity (consumption when free), breakpoint (first price at which consumption is suppressed to 0), maximum output (Omax), maximum price (Pmax, price at which Omax occurred), and elasticity (the ratio of the change in quantity demanded to the change in price). A one-way analysis of variance was used to explore the correlations between the cigarette purchase task indices and socio-demographic and smoking characteristics. The one-way decay model was employed to simulate the smoking cessation rates and determine optimal cigarette prices in a series of scenarios for achieving 20% smoking prevalence.
RESULTS: The price elasticity drawn from CPT was 0.54, indicating that a 10% price increase could reduce smoking by 5.4% in the participated smokers. Smokers with higher income were less sensitive to cigarette prices (elasticity=-2.31, P=0.028). Cigarette purchase task indices varied significantly among the smokers with different prices of commonly used cigarettes, tobacco dependence, and smoking volume. The smokers who consumed cigarettes of higher prices reported higher breakpoint, Omax and Pmax, but lower intensity (P=0.001). The smokers who were moderately or highly nicotine dependent reported higher intensity, breakpoint, Omax and Pmax, and they had lower intensity (P=0.001). The smokers who had a higher volume of cigarettes reported higher intensity and Omax, and lower intensity (P < 0.001). To achieve the goal of reducing smoking prevalence to 20% in mainland China, we estimated the desired increase on smoking cessation rate and prices accordingly in a series of scenarios, considering the gender variance and reduced smoking initiation. In scenario (a), to achieve a smoking prevalence goal of 20%, it would be necessary for 24.81% of the current smokers to quit smoking when there were no new smokers. Our fitting model yielded a corresponding value of 59.64 yuan (95%CI 53.13-67.24). Given the assumption in scenario (b) that only males quitted smoking, the desired cessation rates would be 25.82%, with a higher corresponding price of 62.15 yuan (95%CI 55.40-70.06) to induce desired cessation rates. In the proposed scenario (c) where 40 percent of the reduction in smoking prevalence came from reduced smoking initiation, and females and males equally quitted smoking due to increased cigarette prices, the price of a pack of cigarettes would be at least 37.36 yuan (95%CI 32.32-42.69) (equals to $ 5.20) per pack to achieve the cessation rate of 14.89 percent. In scenario (d) where only males quitted smoking due to increased cigarette prices considering the reduced smoking initiation, the respective smoking cessation rates should be 15.49% with the desired prices of 38.60 yuan (95%CI 33.53-44.02). After adjusting for education levels and income levels in scenario (c), the price of cigarettes would be at least 37.37 yuan/pack (equals to $ 5.20) (95%CI 30.73-44.94) and 37.84 yuan/pack (equals to $ 5.26) (95%CI 31.94-44.53), respectively.
CONCLUSIONS: Cigarette purchase task indices are significantly associated with income levels and prices of commonly used cigarettes, levels of tobacco dependence, and smoking volume, which is inspiring in studying price factors that influence smoking behavior. It is suggested that higher cigarette prices, surpassing the current actual market level, is imperative in mainland China. Stronger policy stra-tegies should be taken to increase tobacco taxes and retail cigarette prices to achieve the Healthy China 2030 goal of reducing smoking prevalence to 20%.